After involution of an infantile hemangioma is complete, what is the treatment of choice?

• A. Observation
• B. Radiation therapy
• C. Surgical excision
• D. Elective surgical excision

Answer: (D)

Infantile hemangiomas typically proliferate and then involute over time, eventually becoming inactive. When involution is complete, there is no active tumor to treat, but residual tissue or scarring can cause cosmetic or functional concerns. In such cases the definitive way to improve appearance and contour is elective surgical excision of the residual tissue. Radiation therapy is not appropriate due to long‑term risks, and observation would be chosen only if there were no residual deformity. Thus, elective surgical excision is the appropriate choice after involution to optimize final appearance.